Massive spontaneous subconjunctival hemorrhage in a patient on therapeutic warfarin: A case report

PURPOSETo describe a case of massive spontaneous subconjunctival hemorrhage in a patient taking warfarin with a therapeutic international normalized ratio (INR). OBSERVATIONSMassive circumferential hemorrhagic chemosis, extensive periorbital and facial ecchymosis, and active arterial extravasation i...

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Bibliographic Details
Published in:American journal of ophthalmology case reports 2021, Vol.22, p.101049-101049
Main Authors: Philip, Andrew M, Fry, Matthew V, Hermanson, Meghan E, Kelly, Lisa D
Format: Report
Language:English
Online Access:Get full text
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Summary:PURPOSETo describe a case of massive spontaneous subconjunctival hemorrhage in a patient taking warfarin with a therapeutic international normalized ratio (INR). OBSERVATIONSMassive circumferential hemorrhagic chemosis, extensive periorbital and facial ecchymosis, and active arterial extravasation in the subconjunctiva which required cessation and reversal of anticoagulation. Findings gradually resolved over several months after discharge. CONCLUSIONS AND IMPORTANCEWhile subconjunctival hemorrhage, even in anticoagulated patients, is usually benign, rare examples of severe presentations exist. We present, to our knowledge, the first documented case of a subconjunctival hemorrhage necessitating cessation and reversal of anticoagulation in the setting of a therapeutic INR.
ISSN:2451-9936
DOI:10.1016/j.ajoc.2021.101049